To evaluate the prognostic value of automated quantification of breast arterial calcification (BAC) on screening mammography for predicting major adverse cardiovascular events (MACE) and mortality.
Approach:
Key Findings:
BAC detected in 16.1% of Emory cohort and 20.6% of Mayo cohort.
Event rates for MACE increased with BAC severity: 5.96 per 1,000 person-years (no BAC) to 48.89 (severe BAC).
Each 1 mm² increase in BAC area correlated with a 1% to 2% increase in cardiovascular risk.
BAC remained an independent predictor of MACE after adjusting for the PREVENT score.
Adding BAC to the PREVENT model improved discrimination in both cohorts.
Interpretation:
Automated BAC quantification from routine mammography may serve as an effective cardiovascular risk assessment tool for women, enhancing existing risk models without additional radiation exposure.
Limitations:
Study was retrospective and dependent on electronic health record data.
Missing variables such as menopause status and reproductive history.
PREVENT scores could only be calculated for a subset of patients due to incomplete clinical data.
Conclusion:
Automated BAC quantification could provide significant prognostic value in assessing cardiovascular risk in women undergoing routine mammography.
Neighborhood vulnerability was associated with poorer survival among women with epithelial ovarian cancer, with a stronger association among Black women.
